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Individual

IMAN MATTOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
8080 E CENTRAL AVE STE 250, WICHITA, KS 67206
(316) 686-7327
(316) 686-1557
Mailing address
8080 E CENTRAL AVE STE 250, WICHITA, KS 67206-2367
(316) 686-7327
(316) 686-1557

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95199822
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
558169
KS

Other

Enumeration date
11/09/2021
Last updated
01/22/2025
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